Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Kelly Marie Goodwin

Behavior Analyst β€’ Rockford, IL

Active NPI 1972078392 Individual Practitioner Female Practitioner
Practice location in NPPES

2990 N Perryville Rd
Rockford, IL 611076814

Call 8154691500 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

2990 N Perryville Rd

Rockford, IL 611076814

Telephone 8154691500
Organization at the Same NPPES Address or Phone
Westside Aba Facility NPI 1245585777

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Mokena, IL. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Rockford and Illinois

18 active clinicians are listed under Behavior Analyst with a practice address in Rockford, IL (3,085 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Rockford

0% of these 18 clinicians have the CMS telehealth indicator.

0% of these 18 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-07-12
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

License # reported to NPPES IL 1-18-31541

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Secondary Practice Locations

9500 Bormet Dr Ste 201

Mokena, IL 604488399

Phone: 8154691500

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
NPI 1013575232

Doctor of Physical Therapy

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location July 12, 2022

Registered at 2990 N PERRYVILLE RD, ROCKFORD, IL 611076814 (Tel: 8154691500)

πŸ“
Updated Business Mailing Address July 12, 2022

Registered at 2990 N PERRYVILLE RD, ROCKFORD, IL 611076814 (Tel: 8154691500)

πŸ“
Updated Practice Location April 29, 2022

Registered at 9500 BORMET DR STE 201, MOKENA, IL 604488399 (Tel: 8154691500)

πŸ“
Updated Business Mailing Address April 29, 2022

Registered at 9500 BORMET DR STE 201, MOKENA, IL 604488399 (Tel: 8154691500)

βœ…
NPI Profile Active October 11, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) October 11, 2018

Registered at 5 REVERE DR STE 120, NORTHBROOK, IL 600628005 (Tel: 7086510527)

πŸ“
Business Mailing Address (Initial Record) October 11, 2018

Registered at 2107 CORONET RD, LOVES PARK, IL 611113212 (Tel: 7086510527)

πŸ‘€
Provider Name / Credentials (Initial Record) October 11, 2018

Recorded as KELLY GOODWIN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 11, 2018

Behavior Analyst (license number reported to NPPES: IL 1-18-31541)

🟒
Initial NPI Registration & Enumeration October 11, 2018

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1972078392
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 11, 2018
Last Update: July 12, 2022
Sole Proprietor: No

Mailing Address

2990 N Perryville Rd

Rockford, IL 611076814

Phone: 8154691500

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.